MEDICARE: GLADELL E CIMA ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	2816P	KY

General Provider Information

NPI Number	:	1649335225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLADELL E CIMA ARNP

Provider Business Mailing Address
First Line	:	9900 BREN RD E
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55343-9664
Country	:	US
Telephone Number	:	502-727-4931
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 STEVENS AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-1044
Country	:	US
Telephone Number	:	502-451-7330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	02/16/2023

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